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外阴恶性外周神经鞘瘤,一种对外阴肿块不常见的鉴别诊断。

Malignant peripheral nerve sheath tumor of the vulva, an unusual differential diagnosis for vulvar mass.

作者信息

Ozdal Bülent, Oz Murat, Korkmaz Elmas, Ataoğlu Omür, Güngör Tayfun, Meydanli Mehmet Mutlu

机构信息

Department of Gynecological Oncology, Zekai Tahir Burak Women's Health Hospital, Ankara, Turkey.

Department of Pathology, Mikro-pat, Ankara, Turkey.

出版信息

Int J Surg Case Rep. 2014;5(11):793-5. doi: 10.1016/j.ijscr.2014.09.006. Epub 2014 Sep 16.

Abstract

INTRODUCTION

Malignant peripheral nerve sheath tumors (MPNSTs) are rare, up to one half of the MPNSTs occur in patients with neurofibromatosis type-1 (NF-1), while the rest are sporadic. Here, we present a 52-year-old woman with MPNST of the vulva without NF-1. We will discuss basics of the disease, treatment options and follow-up strategies.

PRESENTATION OF CASE

52-year-old female admitted to our hospital with complaint of abnormal uterine bleeding and rapidly growing vulvar mass. Excisional biopsy of the mass showed MPNST of the vulva. Afterwards, the patient underwent radical vulvectomy with inguinofemoral lymph node dissection. Short after the surgery, multiple lung metastasis were shown and responded to chemotherapy, but rapid local recurrence occurred short after the completion of the chemotherapy.

DISCUSSION

The primary treatment option in MPNSTs is surgical excision with or without adjuvant therapy. There is not enough data about the role of systemic chemotherapy in the management of MPNSTs and it still remains controversial.

CONCLUSION

In general, radiation therapy has not been demonstrated to improve overall survival. Complete surgical resection of the primary tumor is the mainstay of the treatment.

摘要

引言

恶性外周神经鞘瘤(MPNSTs)较为罕见,高达一半的MPNSTs发生于1型神经纤维瘤病(NF-1)患者,其余为散发性。在此,我们报告一例52岁无NF-1的外阴MPNST女性患者。我们将讨论该疾病的基础知识、治疗选择及随访策略。

病例介绍

一名52岁女性因异常子宫出血及迅速增大的外阴肿物入院。肿物切除活检显示为外阴MPNST。之后,患者接受了根治性外阴切除术及腹股沟股淋巴结清扫术。术后不久出现多处肺转移,对化疗有反应,但化疗结束后不久局部迅速复发。

讨论

MPNSTs的主要治疗选择是手术切除,可辅助或不辅助治疗。关于全身化疗在MPNSTs治疗中的作用,尚无足够数据,仍存在争议。

结论

总体而言,放疗尚未被证明可提高总生存率。原发肿瘤的完整手术切除是治疗的主要手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0664/4245674/af3e99104049/gr1.jpg

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